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Biomedical subjects

E Taniguchi

Publications and source records attributed to E Taniguchi.

At least 73 records · Page 4Linked to original sources
PubMed1997

[A case of infected subdural hematoma complicating chronic subdural hematoma in a healthy adult man].

The authors report a case of so-called "infected subdural hematoma" as a complication of chronic subdural hematoma. The patient was a 55-year-old man who had sustained a small laceration of the forehead in a traffic accident on March 29, 1995. No fractures were detected on skull roentgenograms, and general and neurological examinations failed to reveal any abnormal findings. In early August 1995, the patient began to experience headaches, and on August 5 he developed a fever of 38 degrees C. On August 8 he suffered a left motor seizure and was admitted to our hospital. Laboratory studies revealed a peripheral leukocyte count of 10,800/mm3 and a C-reactive protein level of 18.1 mg/dl. Computed tomography scans showed a thick right fronto-parietal subdural low density mass and a thin left frontal subdural low density mass. An emergency operation was performed via a single right fronto-parietal burr hole. A chronic subdural hematoma containing slightly yellowish, bloody, purulent fluid was found beneath an outer membrane. The hematoma was irrigated with physiological saline containing antibiotics, and a drain was inserted into the subdural space. A subdural membrane was also present on the left but it contained no pus. Aggressive antibiotic therapy was performed, and the patient was discharged without any neurological deficit. Histologically the membrane was determined to be the outer membrane of a typical chronic subdural hematoma. Enterococcus faecalis, which has rarely been reported to cause infection of the central nervous system, was detected in a bacterial culture of the pus. Systemic investigation showed no evidence of otorhinologic or other focal infection. The above clinical findings suggested that hematogenous seeding of a chronic subdural hematoma had occurred in this patient. Subdural empyema arising from hematogenous seeding to a pre-existing subdural hematoma by an infection is very rare, but this type of complication must be kept in mind not only in the elderly, infants, and compromised hosts, but in patients without complications as well.

Chronic Disease↗
PubMed1997

Consecutive maintenance of human solitary and hereditary colorectal polyps in SCID mice.

Recently, the sequential changes from adenoma to adenocarcinoma have been well studied in human colorectal carcinogenesis. To study the precise clonal changes from colorectal polyps to cancer, we have established an experimental system to maintain human colorectal polyps in severe combined immunodeficient (SCID) mice that have been improved by the selective inbreeding of C.B17-scid/scid homozygous male and female showing undetectable serum IgG and IgM (< 1 microgram/ml). Two of two solitary polyps from two nonhereditary colon polyp patients, four of five colon polyps from two Peutz-Jeghers' syndrome patients and one polypoid lesion from a familial polyposis coli (FAP) patient grew very slowly but steadily, at approximately one-tenth the rate of their malignant form, (i.e., adenocarcinoma), in the improved SCID mice and were maintained for a long period (more than 2 years), over several mouse generations. However, two polyps from FAP and Peutz-Jeghers' syndrome patients could not be transplanted further because of microinfection at the transplanted site due to incomplete sterilization of original human tumors prior to surgical operation (endoscopic polypectomy). Transplanted colon polyps had a semitransparent, soft and sticky appearance, with cells containing large amounts of mucin. Malignant transformation of human colon polyp to adenocarcinoma has not been observed during the maintenance period (about 2 years) in SCID mice. In the consecutively maintained human colon polyps, however, K-ras mutations were detected at codon 12, while these mutations were not found in their original polyps in the patients.

Adenomatous Polyposis Coli↗
PubMed1997

[Magnetic resonance imaging of Kernohan's notch in chronic subdural hematoma].

Compression of the crus cerebri against the free edge of the tentorium contralateral to a supratentorial mass, the so-called Kernohan's notch, can be a cause of false localizing sign. Kernohan's notch has been thoroughly studied clinically and pathologically, but not radiographically. The authors describe a case of left chronic subdural hematoma, which resulted in left hemiparesis caused by Kernohan's notch. Injury to the contralateral cerebral peduncle was clearly shown by magnetic resonance imaging (MRI) performed in the postoperative period. A 43-year-old man was transferred to our hospital in deep coma with dilated pupils, unreactive to light. Computed tomography (CT) scans obtained on admission revealed a left chronic subdural hematoma and a midline shift to the right. After drainage and irrigation of the left chronic subdural hematoma through a single burr hole, his clinical condition improved gradually. But 1 month after the operation, mild left hemiparesis still persisted. MRI T2-weighted images demonstrated an abnormally increased signal area in the right cerebral peduncle. T1-weighted coronal images showed the anatomical relationship between the hypointense lesion in the right cerebral peduncle and tentorial edge. Three-dimensional-MRI (3D-MRI) clearly demonstrated the surface image of Kernohan's notch. We emphasize the utility of 3D-MRI for detecting evidence of brain stem injury, such as Kerno han's notch.

Adult↗
PubMed1997

A simple approach to single-cell microdissection and molecular analysis.

OBJECTIVE: To develop a simple approach to single-cell microdissection from Papanicolaou-stained smears and to determine its usefulness in molecular diagnosis using archival cytologic material. STUDY DESIGN: Culture cells from three cell lines (TT, A549 and Lu65) were used to prepare Papanicolaou-stained smears. Mount-Quick, a mounting medium, was used to establish the method of sorting target single cells from smear slides under direct microscopic observation. Calcitonin receptor gene and codon 12 of the K-ras oncogene were amplified to check the application of single-cell genetic analysis in cytology. RESULTS: The target single cell could be simply sorted from Papanicolaou-stained smears using the Mount-Quick microdissection technique. Boiling in water was more suitable for preparing DNA from a single cell or from fewer than five cells versus other methods. Analysis of calcitonin receptor gene and K-ras codon 12 demonstrated that molecular analysis was applicable to a single cell or a few cells from archival Papanicolaou-stained smears. CONCLUSION: This approach has significant implications for cytology: (1) it circumvents the limitations of molecular analysis in cytology and makes the combination of molecular analysis and morphologic diagnosis possible in cases with limited materials; (2) the remaining part of the smear is still preserved well for additional analysis; and (3) the approach is simple, economical and practical for cytology as well as histology.

DNA, Neoplasm↗
PubMed1996

Intraoperative manometry during laparoscopic operation for esophageal achalasia: does pneumoperitoneum affect manometry?

The effects of pneumoperitoneum on the lower esophageal sphincter (LES) were evaluated during laparoscopic operation for esophageal achalasia. Intraoperative manometry was performed in three patients who underwent laparoscopic cardiomyectomy with Dor's fundoplication and five patients who underwent laparoscopic cholecystectomy (LC). The LES pressure and the length of the high-pressure zone (HPZ) did not change during pneumoperitoneum in either the achalasia and the LC group. In the achalasia group the LES pressure was sufficiently decreased following completion of cardiomyectomy, and the length of the HPZ was found to be sufficiently long after completion of fundoplication. The postoperative courses of the achalasia patients were uneventful, and they have had no symptoms of achalasia or gastroesophageal reflux since the operation. Accordingly, intraoperative manometry during 12 mmHg pneumoperitoneum was considered to be available for laparoscopic surgery for esophageal achalasia.

Adult↗
PubMed1996

[A case of cranial hypertrophic pachymeningitis with intracranial hemorrhage].

A case of cranial hypertrophic pachymeningitis of unknown etiology in a patient with 15-year history of headaches, cranial nerve palsies, and gait disturbance is reported. A 77-year-old woman was brought to our institute in a coma. CT revealed intracerebral hemorrhage in the right temporal lobe and thickening of the falx and tentorium. Fifteen years previously the patient had undergone CT scanning because of headaches, cranial nerve palsies, and progressive gait disturbance and a thickened tentorium, mild hydrocephalus and edematous change in the right temporal lobe had been reported. Since the etiology of her symptoms was unclear at the time, she did not receive adequate treatment. Her symptoms gradually progressed thereafter, and her visual acuity and hearing deteriorated. MR imaging in 1994 showed the thickened tentorium as a hypointense area with hyperintense edges on Gd-DTPA enhanced images. Angiography revealed narrowing of posterior portion of the superior sagittal sinus. The patient's condition rapidly deteriorated due to the intracranial hypertension and she subsequently died. Autopsy revealed a thickened tentorium with xanthochromic surface. This hypertrophic change was also seen in the dura mater of the posterior and middle cranial fossa. Microscopic examination of the thickened tentorium revealed extensive fibrous tissue with a chronic inflammatory infiltrate, predominantly of lymphocytes. No specific lesions were revealed by staining with hematoxylin-eosin, PAS, Gram's or Ziehl-Neelsen stains. The patient had no inflammatory or infectious diseases of other organs, and a diagnosis of idiopathic cranial hypertrophic pachymeningitis of unknown etiology was made. Considering the above findings, the thickened tentorium depicted as a hypointense area on the T1- and T2-weighted images and the Gd-enhanced edges of the tentorium are thought to be represent fibrous tissue and inflammatory regions, respectively.

Aged↗
PubMed1996

[Adult-onset aqueductal stenosis caused by membranous occlusion in the aqueduct: a case report].

The authors report a case of adult-onset aqueductal stenosis caused by membranous occlusion of the aqueduct. The patient was a 35-year-old man, who suffered from progressive headache. On admission, computed tomography (CT) scan showed marked dilatations of the lateral and third ventricles. Midsagittal T1-weighted magnetic resonance imaging (MRI) scan showed a membranous occlusion at the lower end of the aqueduct, with dilatation of the proximal aqueduct and elevation of the tectum. Midsagittal cine-MRI demonstrated the cerebrospinal fluid flow in the aqueduct. The patient was diagnosed as having hydrocephalus resulting from membranous stenosis of the aqueduct by MRI. A ventriculo-peritoneal shunt operation was performed and his symptoms improved markedly. The membranous occlusion of the aqueduct is a rare cause of hydrocephalus. The etiology and therapy of aqueductal stenosis are discussed.

Adult↗
PubMed1996

[A case report of volatile solvent psychosis].

A case (male, 27 years old) with chronic thinner intoxication, whose mental condition was reexamined in accord with a court order, is reported. He had been sniffing thinner from age 12 to 27. Since the age of 17, he experienced visual and auditory hallucinations without sniffing thinner. He had no family history of schizophrenia. The psychiatric examination revealed that he had positive symptoms of schizophrenia, especially the first rank symptoms, such as auditory hallucinations (i.e. voices commenting and voices arguing), experience of influence (withdrawal of thought, thought insertion and influence of thought) and delusional perception, but did not show negative symptoms (i.e. blunting thought). Furthermore, he could maintain good emotional contact with others. Hallucinations, which appeared in acute intoxication with thinner, were second rank symptoms, different from those observed in the sober period when he was not under the influence of the thinner. Judging from above facts it was difficult to diagnose this case as schizophrenia or the flashback phenomenon of thinner dependence. Although the disease concept of volatile solvent psychosis has not been clearly established, this case may suggest that the first rank symptoms are important manifestations of volatile solvent psychosis.

Adult↗
PubMed1995

Laparoscopic extramucosal myectomy with anterior fundoplication (Dor) for esophageal achalasia using intraoperative manometry.

Laparoscopic extramucosal myectomy with anterior fundoplication according to the Dor technique was performed on a 24-year-old-woman. Intraoperative inflation of a pneumatic balloon made the operative procedures such as extended submucosal dissection quite easy. Intraoperative gastrofiberscopy was useful for confirming that the remaining mucosal layer was not injured after completion of myectomy. Intraoperative manometry confirmed a complete decompression of the high-pressure zone in the lower esophageal sphincter. Complete relief of the symptoms has been recognized for 6 months after operation without any medication. It is considered that these laparoscopic procedures including intraoperative inflation of a pneumatic balloon, gastrofiberscopy, and intraoperative manometry can be used as a standard operation for esophageal achalasia.

Adult↗
PubMed1995

Choroid plexus carcinoma in the lateral ventricle--case report.

A 68-year-old male presented with choroid plexus carcinoma in the left lateral ventricle manifesting as dysarthria and gait disturbance. Magnetic resonance imaging showed a homogeneously enhanced mass in the trigone of the left lateral ventricle. Selective left posterior cerebral arteriography showed the tumor was fed by the left medial posterior choroidal artery. Detailed examinations found no evidence of an extraneural primary focus. He underwent partial removal of the tumor followed by local Lineac irradiation (50 Gy). After irradiation, the serum level of carcinoembryonic antigen decreased and the size of the residual tumor was reduced.

Adenocarcinoma↗
PubMed1995

[A case of dural arteriovenous malformation in the anterior fossa associated with an occlusion of the unilateral middle cerebral artery with moyamoya phenomenon].

The authors report a case of dural arteriovenous malformation (dAVM) in the anterior fossa that was associated with an occlusion of the unilateral middle cerebral artery with Moyamoya phenomenon. The patient was a 79-year-old man referred to our department with an episode of consciousness disturbance and headache. Computed tomography scan showed intracerebral hematoma in the left frontal lobe, combined with left frontal subdural hematoma and subarachnoid hemorrhage. Angiography revealed dAVM in the left anterior fossa, fed by the bilateral ethmoidal and the bilateral middle meningeal arteries, and draining into the superior and inferior sinuses through the pial veins with vascular sacs. While angiography revealed an occlusion of the right middle cerebral artery (M1 portion) good collaterals via leptomeningeal anastomosis had developed. T1-weighted magnetic resonance (MR) images showed an intracerebral hematoma as a low intensity area, and flow-void areas were indicative of vascular sacs. Time-of-flight MR angiography also clearly showed dAVM in the left anterior fossa. Co-existence of an occlusion of an intracranial major artery and dAVM in this location has not been reported previously and it was speculated that this association had occurred by chance.

Aged↗
PubMed1994

[A case of hemangioblastoma in the thalamus].

Supratentorial hemangioblastoma is encountered very rarely. About 80 cases in all have been reported. The authors present a case of supratentorial hemangioblastoma in the thalamus with gradually enlarging cysts. The patient was a 45-year-old man with complaints of left hemiparesis and headache. Computed tomographic scans of the brain showed a cystic mass with mural nodule in the right thalamus. Left vertebral angiography demonstrated a vascular tumor fed by a thalamogeniculate artery. A right temporo-parietal craniotomy was performed and the tumor was totally resected through the transcortical approach. The histological diagnosis was hemangioblastoma. Post-operative course was good except for a minor complication of the left lower quadrant homonymous hemianopsia and left hemiparesis which had disappeared at the time of discharge.

Hemangioblastoma↗
PubMed1994

[Two cases of traumatic intracerebral pneumocephalus].

Two cases of traumatic intracerebral pneumocephalus, a rare complication of head trauma, are presented. Case 1: A 14-year-old boy had a strong concussion in his forehead due to a motorbike accident. Slightly obtunded on admission showing GCS 10, he became conscious in several days. Head CT performed after 17 days showed a round air image in the right frontal lobe which kept increasing in size thereafter. Bilateral frontal craniotomy was performed 31 days after the injury. A craniodural defect with a herniated brain was found in the superior wall of the posterior ethmoid sinus and repaired. Case 2: A 55-year-old man received a left forehead concussion when his motorbike ran into a car from behind. Although he had been conscious ever since admission, head CT after 15 days showed a round air image in the left frontal lobe. MRI demonstrated the air to be located in the cerebral parenchyma distinctly and the brain to have herniated into the frontal sinus. As the air showed a tendency to increase in volume and mild psychic and memory disturbances appeared, bilateral frontal craniotomy was performed 34 days after the injury. A craniodural defect with a herniated brain was detected in the posterior wall of the frontal sinus and repaired. These two patients showed a small amount of cerebrospinal fluid (CSF) rhinorrhea before the operation. Following the surgical repair, no recurrence of pneumocephalus and CSF rhinorrhea has been seen in either case. Intracerebral pneumocephalus secondary to closed head trauma was thought to have been due to herniation of contused brain into a craniodural defect.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[A case of brain abscess of the basal ganglia which resulted in disastrous outcome due to ventricular ruptures].

A case of deep-seated brain abscess that ruptured twice into the ventricle and resulted in death is presented. A 45-year-old man had experienced pyrexia and headache for 3 days before admission. On admission he was somnolent (GCS: 13) but there were no abnormal neurological findings except nuchal rigidity and Kernig's sign. Computed tomography (CT) scan showed a ring enhanced mass near the left caudate head and dilated ventricles. In comparison with CT performed at the former hospital it was diagnosed that a rupture into the ventricle of the brain abscess had occurred. Ventricular drainage was performed at once and white purulent cerebrospinal fluid was obtained. Thereafter, he was treated with some antibiotics and his conditions seemed to stabilize for a while. Serial CT images demonstrated that the size of the abscess seemed to be enlarging. Just when we planned to undertake stereotactic aspiration, the second ventricular rupture occurred and he died. According to this case, it is suggested that once a deep-seated brain abscess near the ventricular system is suspected, it should be aspirated by means of CT-guided stereotactic surgery immediately.

Basal Ganglia Diseases↗
PubMed1993

Aneurysm of the right gastroepiploic artery: a case report of laparoscopic resection.

A traumatic pseudoaneurysm of the right gastroepiploic artery in a 55-year-old woman was resected using laparoscopy. The durations of anaesthesia and operation were 260 and 220 min respectively. Blood loss was minimal. The perioperative period was uneventful; the patient needed no analgesic treatment and ate her first meal on the morning of the day after surgery. She was discharged 5 days later and has progressed well for 5 months since surgery without any abnormal findings.

Abdominal Injuries↗